Renal Acid-Base Balance

Renal Acid-Base Balance

To the tune of “Driving Sideways” by Aimee Mann 

[Verse 1]
Bicarbonate combines with a proton
And with help of carbonic anhydrase
Forms water and CO2
Which can easily diffuse
Into the IF where it’s converted back to bicarbonate

[Chorus]
Kidneys correct for disturbances in pH
With incompletion titration
Of a proton against a bicarbonate
Leads to elimination
Of either one

 [Verse 2]
The most abundant mechanism
Requires sodium-proton exchange
Sodium-potassium pump
Drives an inward flux of sodium
It cannot secrete protons against a low pH

[Chorus] 
Kidneys correct for disturbances in pH
With incompletion titration
Of a proton against a bicarbonate
Leads to elimination
Of either one

[Bridge] 
The less abundant mechanism
Requires primary active transport
Two proton ATP-ases
Secrete against a low pH
This is a much more powerful mechanism for

[Chorus]
Kidneys correct for disturbances in pH
With incompletion titration
Of a proton against a bicarbonate
Leads to elimination
Of either one